Comparative study of PAP smear and colposcopy with cervical biopsy

Background: Cervical Cancer is the second most common cancer among women worldwide approximately 80% of which occurred in developing countries. Out of all cervical cancer cases seen in the world, only 14% are in the developed countries, while about 86% occurs in the developing countries. The Cervical cancer is the leading cause of cancer in Indian women. Cervical cancer is usually preceded by a long phase of cytological changes, known as cervical intraepithelial neoplastic (CIN) and takes a long period of 15-20 years before the invasive cancer develops". Thus cervical cancer can be prevented if cellular changes are detected and treated in early stage. World Health organization considers cervical cancer as a preventable disease. This is because it can be diagnosed in its precancerous phase. So we have done study to study efficacy of pap smear and colposcopy. Comparative study of PAP smear and colposcopy with cervical biopsy in women with symptomatic/ unhealthy cervix.Methods: All the high risk women of reproductive, perimenopausal and postmenopausal age group who presented with unhealthy cervix on naked eye examination, abnormal vaginal discharge, post coital bleeding, intermenstrual spotting/bleeding, cervix that bleeds on touch and abnormal uterine bleeding. An informed consent was obtained before performing Pap's smear and colposcopy. In case there was abnormal cytology report, the patient's cervical biopsy was done.Results: The sensitivity of Pap smear is 50%, specificity is 86.6%, positive predictive value (PPV) 37.8%, and negative predictive value is 91.4%. The sensitivity of coloposcopy smear is 96.4, specificity is 39.53 and positive predictive value (PPV) 20.61%, negative predictive value is 98.55%.Conclusions: Colposcopy is definitely more sensitive and accurate than pap smear. By combining Pap smear with colposcopy, we can maximize the sensitivity and specificity of cancer cervix screening.